AUTOLOGOUS MARROW TRANSPLANTATION FOR PATIENTS WITH ACUTE NONLYMPHOBLATIC LEUKEMI

自体骨髓移植（AMT）在骨髓移植中的作用 急性非淋巴细胞白血病（ANL）患者的治疗 将被评估。 一项随机试验将在 与西南肿瘤组（SWOG）合作，以确定 AMT的有效性和合适的时机。 ANL患者， 达到缓解将进行HLA分型。 那些有匹配捐赠者的人 将接受同种异体移植 那些没有匹配的 捐赠者将在4-氢过氧环- 磷酰胺（4-HC）处理。 然后他们将被随机分配到 首次缓解时接受AMT或接受高剂量治疗 AMT联合化疗保留至首次复发。 这将允许比较：1）自体移植物与 首次完全缓解的同种异体移植和2）首次完全缓解的自体移植 完全缓解与保留自体移植的化疗 直到第一次复发 此外，我们将尝试定义更多 明确了AMI首次复发时的治愈潜力， 移植额外的病人在这个阶段的疾病谁是 未在SWOG研究中注册。

The role of autologous marrow transplantation (AMT) in the treatment of patients with acute nonlymphoblastic leukemia (ANL) will be evaluated. A randomized trial will be carried out in cooperation with the Southwest Oncology Group (SWOG) to determine the efficacy and appropriate timing of AMT. Patients with ANL who achieve remission will be HLA typed. Those with matched donors will be offered allogeneic transplantation. Those without matched donors will have marrow cryopreserved following 4-hydroperoxycyclo- phosphamide (4-HC) treatment. They will then be randomized to receive AMT in first remission or to be treated with high dose combination chemotherapy with AMT reserved until first relapse. This will allow for a comparison of: 1) autografts versus allografts in first complete remission and 2) autografts in first complete remission versus chemotherapy with autografting reserved until first relapse. In addition, we will attempt to define more clearly the curative potential of AMI at first relapse by transplanting additional patients at this stage of disease who are not registered on the SWOG study.